Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02470 | Date 11/12/2018 |
| Token No | SM/18-19/5085 11/12/2018 | Serial | 065 Last Visit: 11/12/2018 |
| Patient Name | Baby DURGA ROY | Contact No | 9903170770 |
| Address | CHATRA PANPARA | Age | 5 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||